Growth of Human Immunodeficiency Virus-Uninfected Children Exposed to Perinatal Zidovudine for the Prevention of Mother-to-Child Human Immunodeficiency Virus Transmission

Briand, Nelly; Cœur, Sophie Le; Traisathit, Patrinee; Karnchanamayul, Varit; Hansudewechakul, Rawiwan; Ngampiyasakul, Chaiwat; Bhakeecheep, Sorakit; Ithisukanan, Jeerapahan; Hongsiriwon, Suchat; McIntosh, Kenneth; Lallemant, Marc

doi:10.1097/01.inf.0000207398.10466.0d

Cited by 23 publications

(26 citation statements)

References 41 publications

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“…However, anti-retroviral drugs prescribed to the mothers might have also contributed. The same observations have been reported by Briand et al (11).…”

Section: Discussionsupporting

confidence: 81%

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

Ono

Santos

Succi

et al. 2008

Braz J Med Biol Res

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The immune consequences of in utero HIV exposure to uninfected children whose mothers were submitted to highly active antiretroviral therapy (HAART) during gestation are not well defined. We evaluated 45 HIV-exposed uninfected (ENI) neonates and 45 healthy unexposed control (CT) neonates. All HIV-infected mothers received HAART during pregnancy, and the viral load at delivery was <50 copies/mL for 56.8%. Twenty-three ENI neonates were further evaluated after 12 months and compared to 23 unexposed healthy age-matched infants. Immunophenotyping was performed by flow cytometry in cord and peripheral blood. Cord blood lymphocyte numbers did not differ between groups. However, ENI neonates had a lower percentage of naive T cells than CT neonates (CD4+, 76.6 vs 83.1%, P < 0.001; CD8+, 70.9 vs 79.6%, P = 0.003) and higher percentages of central memory T cells than CT neonates (CD4+, 13.9 vs 8.7%, P < 0.001; CD8+, 8.6 vs 4.8%, P = 0.001). CD38 mean fluorescence intensity of T cells was higher in ENI neonates (CD4+, 62.2 vs 52.1, P = 0.007; CD8+, 47.7 vs 35.3, P < 0.001). At 12 months, ENI infants still had higher mean fluorescence intensity of CD38 on T cells (CD4+, 34.2 vs 23.3, P < 0.001; CD8+, 26.8 vs 19.4, P = 0.035). Despite effective maternal virologic control at delivery, HIV-exposed uninfected children were born with lower levels of naive T cells. Immune activation was present at birth and remained until at least 12 months of age, suggesting that in utero exposure to HIV causes subtle immune abnormalities.

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“…However, anti-retroviral drugs prescribed to the mothers might have also contributed. The same observations have been reported by Briand et al (11).…”

Section: Discussionsupporting

confidence: 81%

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

Ono

Santos

Succi

et al. 2008

Braz J Med Biol Res

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“…Many previous studies did not report differences between exposed and non-exposed infants. 7,8,11,15,17 However, one previous study reported a lower birth weight in exposed infants, 4 which was likely due to differences in the antiretroviral regimens. In the present study, the infants exposed to prophylactic treatment were heavier for their length than the children who were not exposed; this effect remained over time.…”

Section: Discussionmentioning

confidence: 74%

Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil

et al. 2011

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OBJECTIVE:To evaluate the growth parameters in infants who were born to HIV-1-infected mothers. METHODS:The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied. The average follow-up period for the infected and non-infected children was 15.8 months (variation: 6.8 to 18.0 months) and 14.3 months (variation: 6.3 to 18.6 months), respectively. A mixed-effects linear regression model was used and was fi tted using a restricted maximum likelihood. RESULTS:There was an observed decrease over time in the WAZ, LAZ and WLZ among the infected infants. At six months of age, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.02, 0.59, and 0.63 standard deviations, respectively. At 12 months, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.15, 1.01, and 0.87 standard deviations, respectively. CONCLUSIONS:The precocious and increasing deterioration of the HIVinfected infants' anthropometric indicators demonstrates the importance of the early identifi cation of HIV-infected infants who are at nutritional risk and the importance of the continuous assessment of nutritional interventions for these infants.

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“…[68,69] Longer (>7.5 weeks) in utero exposure to zidovudine was also associated with lower birthweight; however, the growth deficit is mild and dissipates over time. [70] The mechanism for the observed lower birthweight may be related to mitochondrial toxicity and lactic acidemia, [71] or, in the case of PIs, impaired maternal glucose tolerance. [68] Because such studies can be confounded by variations in treatment regimen and clinical status of the mother, further research is needed on the effects of various antiretrovirals on fetal growth.…”

Section: The Effect Of Highly Active Antiretroviral Therapy On Growthmentioning

confidence: 99%

Impact of Antiretroviral Therapy on Growth, Body Composition and Metabolism in Pediatric HIV Patients

Kim

Rutstein

2010

Pediatric Drugs

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Highly active antiretroviral therapy improves survival and growth in children with HIV infection. However, its use can be associated with adverse changes in body composition and metabolism. Bone mineral density can be adversely affected in HIV-positive children due to nutritional compromise or certain antiretrovirals. HIV-associated lipodystrophy, consisting of redistribution of adipose tissue, insulin resistance, and dyslipidemia, has also been described in children. Pediatric HIV patients may be at greater risk for these problems because of their longer potential lifetime exposure to these agents and because childhood is normally a period of rapid growth and tissue accretion. Healthcare providers for children with HIV infection must be aware of the potential complications associated with HIV antiretrovirals so that their antiviral efficacy can be balanced against their risk for side effects. In this review, we discuss the alterations in childhood growth and body composition that occur in HIV-infected children, and describe the impact of antiretroviral therapy on these outcomes. The problem of HIV-associated lipodystrophy syndrome in children is also discussed. Children with HIV should have their growth and body composition systematically monitored. Antiretroviral regimens should be tailored to optimize adherence and viral suppression while minimizing the potential for adverse side effects.

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Growth of Human Immunodeficiency Virus-Uninfected Children Exposed to Perinatal Zidovudine for the Prevention of Mother-to-Child Human Immunodeficiency Virus Transmission

Cited by 23 publications

References 41 publications

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil

Impact of Antiretroviral Therapy on Growth, Body Composition and Metabolism in Pediatric HIV Patients

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